Using a questionnaire mailed to patients
we evaluated the course and natural history of urinary retention in women,
of which the cause is attributed to electromyography abnormality of the
striated urethral sphincter. Previously urinary retention in young women
has often been considered to be due to multiple sclerosis or a manifestation
of a psychogenic disorder.

MATERIALS AND METHODS:

A questionnaire was mailed to 216
women with abnormal sphincter electromyography and urinary retention. Of
the 112 responses we analyzed the 91 from those who had been in complete
urinary retention.

RESULTS:

Mean patient age at the onset of
complete retention was 27.7 years (range 10 to 50). No patients had neurological
features indicating a cauda equina lesion or central demyelination and
none had progressed to features of a general neurological disorder. Mean
maximum bladder capacity at the initial episode of complete retention was
1,208 ml. Of the women 65% reported an event that had apparently precipitated
urinary retention, most commonly a gynecologic surgical procedure using
general anesthesia. Sacral neuromodulation was the only therapeutic intervention
that restored voiding.

CONCLUSIONS:

The concept of an organic cause of
urinary retention in otherwise healthy young women has considerable importance
in terms of correct management. Neurological investigation in these women
does not reveal underlying neurological disease. It is thought that this
disorder is due to a primary failure of relaxation of the striated urethral
sphincter.